Beyond the Steroid Injection: How Aerolase Laser Is Changing the Way We Treat Acne

A Clinical Perspective from Rejuvence Clinic

The Acne Problem

Acne is one of the most common reasons people come to see us, and it is also one of the most misunderstood. For a condition that affects the majority of people at some point in their lives, the quality of treatment available varies enormously, and many patients arrive having tried everything on the high street, several courses of antibiotics, and a drawer full of products, without ever getting to grips with what is actually driving their skin.

Our Evolution in Treatment

At Rejuvence Clinic, our approach to acne has evolved considerably. For years, the most reliable tool we had for a painful, stubborn breakout was the steroid injection. It worked, and it still has its place. But it was only ever part of the answer. 

Today, with the addition of advanced laser technology, we are able to treat not just the lesion in front of us but the underlying processes that keep acne coming back. The results, particularly when treatments are combined, are some of the most consistent we have seen.

What This Article Covers

This article explains how we think about acne, what the steroid injection does well and where it falls short, how Aerolase works, and why combining the two has become our preferred approach for many patients.

Acne Is Not Just a Surface Problem

Understanding the Surface Appearance

It is tempting to think of acne as a skin-deep issue: spots appear, you treat the spots, the spots go. In reality, acne is the visible end point of several processes happening beneath the surface, all feeding into one another.

The Four Driving Factors

Four factors drive most cases:

• Excess sebum. The sebaceous (oil) glands produce too much oil, often under hormonal influence.
• Follicular blockage. Skin cells lining the follicle do not shed normally and clog the pore.
• Bacteria. Cutibacterium acnes (formerly Propionibacterium acnes), a bacterium that lives in the follicle, multiplies in this oily, blocked environment.
• Inflammation. The immune system responds, producing the redness, swelling and tenderness that turn a blocked pore into an angry, inflamed lesion.

Why Acne Persists

The reason acne is so persistent is that these factors reinforce each other. You can attack one and still leave the others driving the condition forward. This is also why a single treatment, used in isolation, so often disappoints. If you only address the bacteria, the excess oil and inflammation remain. If you only calm the inflammation, the underlying drivers are untouched.

The Key to Better Outcomes

Understanding this cascade is the key to understanding why our approach has changed. The best outcomes come from addressing several of these factors at once, rather than chasing individual spots as they appear.

The Steroid Injection: Fast, Effective, but Limited

How Steroids Work

For a long time, the intralesional steroid injection was the most powerful tool we had for inflammatory acne, and it remains genuinely valuable.

When a large, painful cyst or nodule develops, a small, precise injection of corticosteroid (typically triamcinolone, used at a low concentration) calms the inflammation directly within the lesion. The effect can be dramatic and rapid. Patients often report a noticeable reduction in pain within 24 hours, with the lesion flattening over the following two to three days.

When Steroids Are Ideal

For someone with a significant breakout before an important event, or for a single stubborn cyst that will not settle, this remains an excellent option.

Clear Limitations

But the steroid injection has clear limitations, and it is important to be honest about them:

• It treats one lesion at a time. It is a targeted rescue, not a strategy for the whole face.
• It does nothing about the underlying causes. It calms the inflammation in that specific cyst, but it does not reduce sebum production, address the bacteria, or change the behaviour of the sebaceous glands.
• It carries a small risk of skin thinning. If the concentration is too high or injections are repeated too often in the same spot, localised atrophy (a small depression in the skin) can occur. This is why careful, conservative dosing matters.
• It does not prevent the next breakout. Because the underlying drivers are untouched, new lesions continue to form.

The Gap in Care

In other words, the steroid injection is superb at putting out individual fires, but it was never designed to change the conditions that keep starting them. For years, that was the gap in what we could offer. The Aerolase laser has gone a long way towards closing it.

How the Aerolase Laser Works

The Technology Behind Aerolase

The Aerolase Neo is a 1064nm Nd:YAG laser that delivers energy in an extremely short pulse (650 microseconds). That technical detail matters, because Aerolase laser technology allows the laser to deliver meaningful energy to the deeper structures of the skin comfortably and without the need for topical anaesthetic in most cases.

How It Targets Acne Drivers

Crucially, it works on the underlying drivers of acne rather than just the surface:

• It targets the sebaceous glands. The laser energy heats and shrinks the overactive oil glands, reducing the excess sebum that feeds the whole process.
• It reduces the bacterial load. The thermal effect helps suppress C. acnes within the follicle.
• It calms inflammation. By acting on the inflamed tissue and its blood supply, it helps settle the redness and swelling that characterise active acne.
• It improves the aftermath. The same wavelength is well suited to addressing the marks acne leaves behind, including post-inflammatory erythema (lingering redness), some pigmentation, and the texture of certain scars.

Safety Across All Skin Types

There is a further advantage that is particularly relevant for a London clinic treating a genuinely diverse population. The 1064nm wavelength is considered one of the safest laser options across all skin types, including deeper skin tones, where many older devices carried a higher risk of pigmentary side effects. 

This means we can offer laser-based acne treatment to a much wider range of patients than was once possible.

Evidence Base

The evidence base behind this technology has grown substantially. Clinical studies of the 650-microsecond 1064nm Nd:YAG laser have reported marked reductions in inflammatory acne lesions over a course of treatments, alongside high patient satisfaction and a strong safety profile across skin types. 

As with any treatment, individual results vary, but the direction of the evidence is encouraging and consistent with what we see in our own patients.

Why We Now Recommend a Combination Approach

The Shift in Thinking

This is the heart of how our thinking has changed. We no longer view acne treatment as a choice between the steroid injection and the laser. For many patients, the most effective strategy uses both, because they do different jobs.

How They Complement Each Other

Think of it this way:

• The steroid injection delivers rapid relief. When a patient has a painful, inflamed cyst, it settles that lesion quickly and comfortably. It is the immediate rescue.
• The Aerolase laser delivers durable improvement. By acting on the sebaceous glands, the bacteria and the inflammatory environment across the whole treatment area, it works on the drivers that keep producing new lesions. It is the longer-term strategy.

The Synergistic Effect

Used together, the patient gets both: fast resolution of the lesions causing the most distress, and a treatment programme that steadily improves the underlying condition and the appearance of the skin over time. We have found this combination to deliver the kind of visible, sustained improvement that neither approach reliably achieves on its own, which is why it is now what we recommend for many of the patients we see.

Additional Options for Scarring

It is also worth noting that, for patients whose main concern is scarring or textural change left behind by previous acne, we have further options that can be layered into a plan, including Sciton BBL HEROic broadband light and Sylfirm X. The right combination depends entirely on the individual, which is why we plan treatment around the person rather than applying a fixed protocol.

Being Honest About What Treatment Can and Cannot Do

Setting Realistic Expectations

We think it is important to set realistic expectations, because acne is a condition that rewards honesty rather than overpromising.

What Treatment Cannot Guarantee

• No treatment is a permanent cure. Acne is driven by factors that can be controlled and substantially improved, but in some patients the tendency persists, and a maintenance plan may be needed to keep results stable.
• A course is usually required. Meaningful, lasting improvement comes from a series of treatments, not a single session. Skin takes time to respond.
• Severe acne may still need medical therapy. For widespread or severe cystic acne, prescription treatments, including oral medication, remain an important part of the picture. Laser and injection therapy complement these, they do not always replace them.
• Results vary between individuals. Skin type, the type and severity of acne, hormonal factors and lifestyle all influence the outcome.

Our Approach to Care

Our role is to assess your skin properly, explain honestly what is realistic, and build a plan that uses the right tools in the right order for your particular case.

The Rejuvence Approach

Our Clinic Standards

Everything we do with acne is doctor-led and delivered in a CQC accredited clinic, which matters more than it might sound. Acne treatment involves decisions about medication, injection technique, laser settings and skin type that should be made by trained clinicians, not guessed at.

Your Treatment Pathway

A typical pathway with us begins with a proper assessment of your skin and the type of acne you have. From there, we build a plan that may combine:

• Intralesional steroid for acute, painful lesions that need rapid settling.
• A course of Aerolase laser to address sebum, bacteria, inflammation and the marks acne leaves behind.
• Additional technologies such as Sciton BBL HEROic or Sylfirm X where scarring or pigmentation is a particular concern.
• Guidance on skincare and, where appropriate, medical therapy.

Get assessed for acne treatment to find the right combination for your skin type.

Our Commitment to You

The objective is always the same: clearer skin, fewer breakouts, reduced scarring, and a result that holds. We would far rather give you a candid view of what is achievable and a plan built around your skin than sell you a single treatment and hope for the best.

Getting Started

If acne is affecting your confidence and you have not been able to get it under control, we would be glad to assess your skin and talk you through the options. We offer a consultation where we can look properly at what is driving your acne and recommend the most appropriate combination for you.

Disclaimer: This article is intended for general information and education. It does not constitute medical advice, and it is not a substitute for a personalised consultation. Treatment suitability, benefits and risks vary between individuals and should be discussed with a qualified clinician. Individual results cannot be guaranteed.

Selected References

1. Olugbade D, et al. (2025). Treatment of Acne Vulgaris With a 650-microsecond, 1064nm Nd:YAG Laser: A Retrospective Study. Journal of Cosmetic Dermatology.
2. Treatment of Mild to Severe Acne Vulgaris With a 650-Microsecond 1064-nm Nd:YAG Laser. Clinical study report.
3. 650-microsecond 1064nm Nd:YAG Laser Treatment of Acne: A Double-Blind Randomized Controlled Study.
4. Intralesional Corticosteroids for the Treatment of Individual Acne Vulgaris Lesions. (2023). StatPearls / NCBI Bookshelf.
5. Levine RM, Rasmussen JE. (1983). Intralesional corticosteroids in the treatment of nodulocystic acne. Archives of Dermatology, 119(6), 480-481.
6. Targeted Acne Therapy Using Light-Absorbing Gold Microparticles Combined With Long-Pulsed 1064 nm Nd:YAG Laser: A Case Series. (2025). Journal of Cosmetic Dermatology.